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Interventions for High-Risk Groups

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Alcohol harm reduction approaches can be targeted towards specific high-risk groups of alcohol consumers. This section provides some examples of this targeted approach and covers interventions for homeless or street drinkers, intoxicated Aboriginal drinkers, students and young people, drug service clients, and seniors.

Brady M, Nicholls R, Henderson G & Byrne J (2006) The Role of a Rural Sobering-Up Centre in Managing Alcohol-Related Harm to Aboriginal People in South Australia. Drug and Alcohol Review, 25, pages 201 - 206 (PDF, 120 KB)

In Australia, Aboriginal people are a key high-risk population in terms of alcohol misuse and associated harms. ‘Sobering-up centres’ are non-custodial, safe overnight shelters for the publicly intoxicated, and are a popular intervention for managing public drunkenness and acute harms amongst this group. This document evaluates a sobering-up centre in South Australia.

Crane M & Warnes AM (2003) Wet Day Centres in the United Kingdom: A research report and manual. Sheffield: Sheffield Institute for Studies on Ageing (PDF, 278 KB)

In many countries, street drinkers (whether homeless or not) are a particularly high-risk group in terms of alcohol consumption. This document is an overview of day centres in England which formally allow street drinkers to consume alcohol is a safe and controlled environment. It consists of two sections - a literature review on the topic of ‘wet’ day centres, and guidance notes for new services to develop.

Lewis DK & Marchell TC (2006) Safety First: A medical amnesty approach to alcohol poisoning at a U.S. University. International Journal of Drug Policy, 17(4), pages 329 - 338 (PDF, 223 KB)

Around the world, young people of university or college age are often a high-risk group for alcohol-related harms. In the USA, where the legal age for alcohol consumption is 21 years, intoxicated university students are often reluctant to seek help in emergencies through fears of legal repercussions. This document reviews a harm reduction approach to tackle this specific problem by providing a ‘medical amnesty’ scheme to help intoxicated young people.

Mason P & Bennett G (2004) Promoting Safer Drinking: A briefing paper for drug workers. London: National Treatment Agency for Substance Misuse (PDF, 66 KB)

In the UK, alcohol consumption is particularly high amongst clients of services for problematic illicit drug use. In order to target this high-risk group, this document is a guide for drug workers to screen and assess their clients for alcohol problems and provide advice about responsible alcohol use and how to reduce alcohol-related harms.

McBride N, Farringdon F, Midford R, Meuleners L & Phillips M (2004) Harm Minimization in School Drug Education: Final results of the School Health and Alcohol Harm Reduction Project (SHAHRP). Addiction, 99, pages 278 - 291 (PDF, 168 KB)

Young people are widely recognised as a high-risk group for alcohol-related problems, and there has been much debate over the years on how best to target this population. This document evaluates the ‘School Health and Alcohol Harm Reduction Project’ (SHAHRP) – an educational programme in Australia which aimed to reduce alcohol-related harm in secondary school students. Individuals who received the SHAHRP intervention had significantly improved knowledge, attitudes and behaviours.

Podymow T, Turnbull J, Coyle D, Yetisir E & Wells G (2006) Shelter-Based Managed Alcohol Administration to Chronically Homeless People Addicted to Alcohol. Canadian Medical Association Journal, 174 (1), pages 45 - 49 (PDF, 1 MB)

People who are homeless and have alcohol problems often face higher levels of alcohol-related harm – such as health problems and heightened police contact. They can also often find it harder to secure accommodation. This document overviews the shelter-based Managed Alcohol Project (MAP), which was created to deliver targeted health care to homeless adults who misuse alcohol. The intervention helped to stabilise these individuals and significantly decrease alcohol-related harms.

Spencer C (2004) Alcohol and Seniors. Web Resource

Although not a ‘document’ per se, www.agingincanada.ca (hyperlink) is a website dedicated to alcohol issues that affect older people (or “seniors”). Alcohol use and misuse is common amongst seniors, yet this is an often overlooked high-risk population. This website includes a page dedicated to harm reduction - detailing some of the risks faced by older people. It is an excellent resource for reducing alcohol-related harm amongst older people.